DAISY Award—Carol Leija, M.S.N., R.N., O.C.N.

Comprehensive Cancer Center

Carol Leija is the quintessential patient advocate. In her role as Nurse Navigator, Carol bridges acute leukemia patients from inpatient to outpatient care upon completion of induction chemotherapy (initial cancer treatment). Acute leukemia treatment is rigorous, and this vulnerable population will have tremendous healthcare needs. Patients often require frequent MD visits, appointments for twice weekly labs, transfusion support and central line care, just to name a few of their follow-up needs. The transition period after induction therapy requires careful coordination with the outpatient care team. Often, it involves communicating with outside health systems and providers, as many patients travel far distances to receive their induction therapy. It takes a knowledgeable, competent, compassionate and caring nurse to make sure that the patient and their families are supported during this time. Carol is that nurse.

I can name countless situations where I have witnessed Carol going above and beyond to make sure that patients and their families have their outpatient leukemia care in place. She feels a great sense of responsibility for ensuring a smooth, coordinated transition. This usually means working with the inpatient care team, insurance company, outpatient care team, outside healthcare facilities, and the patient and caregivers. To illustrate Carol’s commitment to those she navigates, I'll use a situation that recently occurred. A patient was nearing discharge from the hospital at the end of induction therapy. Carol had proactively placed an insurance authorization request for outpatient care the month and the insurance company indicated that the patient would need to receive care at a local healthcare facility outside UC Davis Health. A few days ago, Carol received a call from the receiving physician at the authorized facility that they could not support the patient's needs due to lack of medical and nurse staffing They requested that Carol identify another outpatient clinic where care could be given. This necessitated a flurry of phone calls from Carol to a number of individuals to ensure that an alternate outpatient facility was identified, and that insurance authorization was obtained. This occurred on a Friday afternoon and could not be resolved before end of business day, but the process was started. As soon as she arrived in the office Monday morning, Carol was back on the phone to ensure that the proper arrangements would be in place before the patient’s discharge. The hard work resulted in authorization for outpatient care at UC Davis Health. Carol’s advocacy prevented fragmentation of care, which can occur when the patient receives care at more than one health system. This is just one of many examples that demonstrate the high level of nurse navigation Carol provides.

As a nurse, I feel that one of the biggest compliments we as healthcare providers can receive is when a colleague or patient tells you that they would want you to take care of a loved one. This is how I feel about Carol. If I myself or someone I love were to develop leukemia, I would want Carol there to help navigate the complicated landscape of hematologic malignancy. She embodies the definition of extraordinary care!